Diagnostic Considerations

Pseudoplateau iris: In pseudoplateau iris, the anterior displacement of the peripheral iris is not caused by an enlarged or anteriorly positioned ciliary body. Cysts of the iris and/or ciliary body neuroepithelium most often are responsible. This condition may be distinguished from plateau iris on gonioscope because the angle is closed in only one quadrant or, if cysts are multiple, at several focal loculations. However, clinical features of pseudoplateau iris often do not discriminate well from plateau iris. Ultrasound biomicroscopy is extremely helpful in identifying the underlying mechanism and guiding therapy.
[8]

Ultrasound biomicroscopy. (A) In plateau iris, the anterior position of the ciliary body holds the peripheral iris against the trabecular meshwork. (B) The angle is obstructed further in the dark as the peripheral iris thickens with physiologic pupillary dilation.

Robert Ritch, MD Shelley and Steven Einhorn Distinguished Chair in Ophthalmology, Chief of Glaucoma Service, Surgeon Director, Professor, Department of Ophthalmology, New York Eye and Ear Infirmary, New York Medical College

Disclosure: Received none from Sensimed for board membership; Received none from iSonic Medical for board membership; Received consulting fee from Aeon Astron for consulting; Received honoraria from Pfizer for speaking and teaching; Received honoraria from Allergan for speaking and teaching; Received honoraria from Ministry of Health of Kuwait for speaking and teaching; Received honoraria from Aeon Astron for speaking and teaching; Received royalty from Ocular Instruments for other.